M dot D almost-dot

Today, I took the written (well, computerized) portion of Step 2 (CK, or "Clinical Knowledge") of the USMLE (Unites States Medical Licensing Exam). There are three steps of general medical "Boards" that we have while in school and before completing intern year (year 1 of residency). The first, Step 1, is, by far, the hardest. We take this after second year of medical school, and it basically tests us on EVERYTHING about medicine, including minutiae of obscure biochemical cycles (quick! What's the third step of the Krebs cycle?!) that we all soon forgot and will never need to know. Doing well on Step 1 is considered very important for to be competitive for residencies (even in Family Medicine, where there are 0.4, yes 0.4, applicants per spot and no, Wendi, I repeat I will not tell you, nor anyone else, what I got on that test). Second year was hard, especially towards the end, with burnout going on and that big test looming over our heads, but it's all been better since then!

The quip for the requirements for the Steps is "2 months (i.e. to study for Step 1), 2 weeks, and No. 2 pencil (Step 3 is supposed to be a breeze!)." So for the past week and half or so, I had been occupying myself with doing massive amounts of practice questions to prepare for the test. It's actually quite rewarding to realize how much we really do know, and what we've learned through the clinical years, for this Step tests our knowledge of diagnosis and management rather than raw basic medical facts. Call me a nerd, but it's actually quite fun to "figure out" what's going on in the clinical scenarios we're presented (and even more fun when you're right!). Passing this test has to be a requirement for graduation. So as long as I show up to my other rotations this year and match somewhere (and pass this test!), I think I will be fairly sure of getting my degree in May! Hence the almost-dot after the D in M.D.! :)

So the test today consisted of 8 blocks of 46 questions each; you are allotted 1 hour per block. It requires endurance for sure, and the ability to stare at a computer for 8 hours. They give you something like 45 minutes of break time to use to break up the blocks. I ended up taking mini-breaks after completing every two blocks of questions and was done by 3:20 or so, which has to be some kind of record for me. I am a slow test-taker. I used most of the time but that's because I compulsively check my answers :) But at least I can maybe say I beat Hans at something, which I've wanted to do since starting medical school (he's SOO good at everything; however, he doesn't take Step 2 for a few weeks so, technically, I finished before him :)) And the questions really weren' t too bad! I think they were overall more straightforward than the practice ones I had done.

Ajit mentioned something to me which made me go back and look at my residency application. I, obviously not thinking about much of anything when I completed it, checked the box which authorizes the immediate release of these scores to all the programs to which I applied. This decision is IRREVOCABLE! Yikes. So apparently the places I applied may know my scores before I do! I wonder how those interviews are going to go ("So, tell me what happened on Step 2..... We really thought you were a good candidate before we got those results...." :)) I've heard it takes something like 3-6 weeks to get the results back... and I'm not sure how I'm going to hear. My mail is currently going to be forwarded to my parents' house in Virginia while I'm on the road. So maybe they'll find out and tell me. Anyway, send lots of happy USMLE thoughts my way in the next few weeks :)

I have to take this Clinical Skills (fake patients with fake problems) practical exam in Chicago in a couple of weeks, but I hear it's not too bad. It's basically simulating what we've been doing for the past couple of years anyway-- taking histories, examining patients, and coming up with a diagnostic and therapeutic plan. In any case, I believe I just took my LAST WRITTEN TEST (or at least one that counts for anything) of medical school. CAUSE FOR CELEBRATION!!!!!!!!